Objective: Hypospadias surgery, especially when performed early in life, may have a significant impact on the urinary and sexual functions in an adult. Because the literature is still limited, this paper assesses long-term functional, cosmetic and sexual results of hypospadias repair performed in childhood. Patients and Methods: The study includes 275 patients older than 12 years treated for a hypospadias by an Onlay, Mathieu, Duplay, or Duckett's technique between January 1990 and December 2000. Flowmetry results were retrospectively obtained from patients' charts. The Paediatric Penile Perception Score (PPPS), the Hypospadias Objective Scoring Evaluation (HOSE) and the IIEF-5 score (when older than 16 years old) questionnaires were used to assess cosmetic and sexual results. The PPPS is designed to assess both penile self-perception with regard to meatus, glans, skin and general appearance. The HOSE is a five-point scoring system designed to allow an objective appraisal of the outcome of hypospadias repair, based on evaluating meatal location, meatal shape, urinary stream, straightness of erection, and the presence and complexity of any complicating urethral fistula. Results: Qmax were within age-adjusted references, independent of the surgical technique, with median (range) Qmax of 18.8 ml/s (range 3-45, n = 136). Patients expressed a high satisfaction for every single item of the penile perception scale (PPPS), with mean values between 2 (satisfied) and 3 (very satisfied). Eighty-two percent were satisfied or very satisfied of the overall evaluation of penile appearance. Eighty-one percent of patients had a normal erectile function (IIEF-5 >22; n = 35/43). Conclusions: Taking into account the limitation of a small number of patients resulting from a low 21% questionnaire's response rate, the results of this study align with previous reports from the literature and confirms that hypospadias repair using standard techniques results in acceptable functional, cosmetic and sexual outcomes. This study highlights the need of developing a set of standard approved outcomes assessments tools for evaluating the long-term impact of hypospadias repair performed in infancy.

Journal Section:
Editor's choice
Keywords:
Hypospadias, Hypospadias-repair, Functional, Flowmetry
1.
Bracka A: Sexuality after hypospadias repair. BJU Int 1999;83(suppl 3):29-33.
2.
Springer A, Krois W, Horcher E: Trends in hypospadias surgery: results of a worldwide survey. Eur Urol 2011;60:1184-1189.
3.
Jiao C, Wu R, Xu X, Yu Q: Long-term outcome of penile appearance and sexual function after hypospadias repairs: situation and relation. Int Urol Nephrol 2011;43:47-54.
4.
Tourchi A, Hoebeke P: Long-term outcome of male genital reconstruction in childhood. J Pediatr Urol 2013;9:980-989.
5.
Rynja SP, de Jong TP, Bosch JL, de Kort LM: Functional, cosmetic and psychosexual results in adult men who underwent hypospadias correction in childhood. J Pediatr Urol 2011;7:504-515.
6.
Baskin LS, Ebbers MB: Hypospadias: anatomy, etiology, and technique. J Pediatr Surg 2006;41:463-472.
7.
Aho MO, Tammela OK, Somppi EM, Tammela TL: Sexual and social life of men operated in childhood for hypospadias and phimosis. A comparative study. Eur Urol 2000;37:95-100.
8.
Mouriquand PD, Persad R, Sharma S: Hypospadias repair: current principles and procedures. Br J Urol 1995;76(suppl 3):9-22.
9.
Mieusset R, Soulié M: Hypospadias: psychosocial, sexual, and reproductive consequences in adult life. J Androl 2005;26:163-168.
10.
Ziada A, Hamza A, Abdel-Rassoul M, Habib E, Mohamed A, Daw M: Outcomes of hypospadias repair in older children: a prospective study. J Urol 2011;185:2483-2485.
11.
Chertin B, Natsheh A, Ben-Zion I, Prat D, Kocherov S, Farkas A, Shenfeld OZ: Objective and subjective sexual outcomes in adult patients after hypospadias repair performed in childhood. J Urol 2013;190:1556-1560.
12.
Hoag CC, Gotto GT, Morrison KB, Coleman GU, Macneily AE: Long-term functional outcome and satisfaction of patients with hypospadias repaired in childhood. Can Urol Assoc J 2008;2:23-31.
13.
Gaum LD, Wese FX, Liu TP, Wong AK, Hardy BE, Churchill BM: Age related flow rate nomograms in a normal pediatric population. Acta Urol Belg 1989;57:457-466.
14.
Mureau MA, Slijper FM, Slob AK, Verhulst FC, Nijman RJ: Satisfaction with penile appearance after hypospadias surgery: the patient and surgeon view. J Urol 1996;155:703-706.
15.
Weber DM, Landolt MA, Gobet R, Kalisch M, Greeff NK: The penile perception score: an instrument enabling evaluation by surgeons and patient self-assessment after hypospadias repair. J Urol 2013;189:189-193.
16.
Holland AJ, Smith GH, Ross FI, Cass DT: HOSE: an objective scoring system for evaluating the results of hypospadias surgery. BJU Int 2001;88:255-258.
17.
Jones BC, O'Brien M, Chase J, Southwell BR, Hutson JM: Early hypospadias surgery may lead to a better long-term psychosexual outcome. J Urol 2009;182:1744-1749.
18.
Woodhouse CR, Christie D: Nonsurgical factors in the success of hypospadias repair. BJU Int 2005;96:22-27.
19.
Aho MO, Tammela OK, Tammela TL: Aspects of adult satisfaction with the result of surgery for hypospadias performed in childhood. Eur Urol 1997;32:218-222.
20.
Xu N, Xue XY, Wei Y, Li XD, Zheng QS, Jiang T, Huang JB: Outcome analysis of tubularized incised plate repair in hypospadias: is a catheter necessary? Urol Int 2013;90:354-357.
21.
Ardelt PU, Cederquist M, Schoenthaler M, Miernik A, Frankenschmidt A: The glandular resection and central embedding modification (GRACE) in Duckett and Barcat hypospadias repair. Urol Int 2013;90:358-364.
22.
Moriya K, Kakizaki H, Tanaka H, Furuno T, Higashiyama H, Sano H, Kitta T, Nonomura K: Long-term cosmetic and sexual outcome of hypospadias surgery: norm related study in adolescence. J Urol 2006;176:1889-1892.
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